Mouth gag or retractor



Jan. l2 1926. y 1,569,504

B. D. LA FoRcE MOUTH GAG OR RETRAGTOR Filed Dec. 1, 1922 5 Sheets-Sheet 2 Elili/"MASS: 25am/effe 0; llajnrce,

Patented Jan. 12, 1926.

UNlED STATES esami BURDETTE D. L51 FQRCE, OF OTTUMWA, IOWA.

MOUTH GAG 0R RETRACTOR.

Application filed December 1, 1922. Serial No. 604,197.

To all C72/enz 'it 92mg/ concern.'

Be it known that I, Bmuurrtrn l). LA FORCE, a citizen of theUnited States, residing at Ottumwa, in the county of VVapello and State of lowa, have invented a new and useful Improvement in Mouth Gags or Retractors, of which the following is a specification.

This invention has relation to surgical instruments, and 'mere particularly to what is commonly known 'as a mouth retract-or or gagy and lcomprises an appliance to be fitted te the head of a patient at the forehead and 'chin and adjusted to retain the mouth in an open position so that the mouth cannotA be closed during examinations and operations made within the mouth upon the teeth, throat, trachea, bronchi, esophagus or stomach.

Numerous devices have been produced to perform the functions above stated, but with these appliances, so far as l am at present aware, it has been the practice to insert or position the instrument either wholly or partia-ily inside the patients mouth so to engage b 'oth the upper and lower' teeth, or the gums if teeth are not present. Such structures have numerous objections, the prnci- 'pal one of which is that with the use of re tractors or gags which engage the teeth, or within the mouth of the patient accidents occur, sometimes unavoidably, involving the breaking of a tooth or teeth, the dislocation of the jaws or other injury to the moilth or lips, which accidents are never' desirable and sometimes involve a very serious and wholly unnecessary source of danger. Another objection to the usual form of mouth retractor or is 'that the operators view is frequently obstructed, and the parts of the appliance within the patients mouth interfere materially with the ready employment of such operating instruments as the surgeon may be using. Also many of the present appliances are so constructed that the patient can move his or her head to positions that are undesirable to the dentist or surgeon performing the operations. It will at once be realized that such a movement on the part of the patient may be highly un .desirable and is disturbing to the operator, and, while it is necessary `te provide against any such contingency, it should not be lost sight of, and it has been one of the objects of my invention to provide a structure which is readily under the control of the surgeon, so that he may wholly release or readjust the position of the patients head without loss of time. It is to overcome the above-stated objections and to obtain the above mentioned adjustments and facilities that the ypresent structure has been devised, and, therefore, the objects of this invention are, first, to provide a structure for retaining the mouth in an opened position without having any part of the instrument coming incontact with the patients upper teeth; second, to provide means for effectively maintaining the head of the patient in a rigid position while holding the mouth open and at the same time affording facilities by means of which the surgeon may wholly disengage or readjust the patients head without loss of time; third, to provide a mouth gag that will be comfortable to the patient and at the same time has a minimum number of parts that will interfere with the work of the operator, and, fourth, to construct the apparatus so that after securing the patient in the desired position the entire structure may be instantly released -to relieve the patient in the event of choking or strangling. Other objects, of course, will be apparent to others skilled in this art after an understanding of the invention is had, and it may be stated that the appliance is easy to manipulate, simple in construction, being made of a minimum number of parts, and is comparatively inexpensive to manufacture so that it may be sold for a reasonable price. The foregoing and other objects are accomplished substantially in the manner hereinafter fully set forth, reference being now had to the accompanying drawings which form a portion of this specification, in which- Fig. l is a side elevation of my invention showing the same in use upon a patient with the mouth closed.

Fig, 2 is a similar View showing the relative position when the mouth has been opened by the Fig. 3 is a plan, partly in section, of the chin @teasing bar and its, meantime',

Fig. 4 is a View at right angle to Fig. 3, the right hand end portion being in section on line 4 4, Fig. 3.

Fig. 5 is a sectional view of my invention drawn partly in elevation, the section being on line 5 5, Fig. 1.

Fig. 6 is a fragmental view oi the latehing means for the forehead plate showing `the saine in a different position.

Fig. 7 is an edge view of the :chin Ibar, and showing the manner of mounting the carrying arms upon `the main support.

Fig. 8 is a iragmental View of my invention illustrating an accessory for' use on patients having subnormal chin formation.

Fig. 9 is a tragmental view showing the manner of mounting the accessory upon the chin bar.

Figure 10'is a perspectiveot the accessory shown in Fig. 8 but detached.

In the accompanying drawings, similar reference characters have rbeen employed to designate the same parts throughout the ,divers views, and by referring to Figs` 1 and 2 it will be seen the retractor or mouth gag is constructed `in the following manner: To a 'head engaging harness or head plate (which may be either separate itrom or attached to a fixed support, such as an operating chair or table), iis secured `by means permitting vthe necessary .pivotal and other adj ustmcnts, instrumentalities for operating `between .the upper and lower jaws and `upper part of the .head Aand necl .for forcing the `lower jaw `downwardly yand posteriorly and holding it in the .desired position.

is `wiill at once fbe seen practically none of the mechanism is within the patients mouth causing a reduced danger of damage, such as the breaking or dislodging of the teeth or lcausing excoriation within the patients mouth orthroat, thus leaving the dentist or surgeon more room to manipulate instruments for examination and operation.

It will bc understood, of course, that,

while the same is not shown, means are` .provided whereby the retractor structure may be mounted acljustably upon the back or other vconvenient portion of a chair, table, the like, .or upon a portable stand, so that after the patient@ month has been .opened by 1the operator the head cannot be moved in any direction, but is held rigid to permit the dentist ,or surgeon to perform operations, but, nevertheless, the operator may quicgldy place the patient ,in any other desired position, or may instantly release him from the structure.

in order to support the structure upon a table, stand, or otherdevice, a post 10 is provided, to the upper end .of which v'is suitably secured a cross piece 11, and from the ends of this cross piece suitable laterally disposed vertical supporting plates 12, 12. extend. These plates l2 which are Counterparts may be of any desired shape, the ones shown heilig trefoil, and in the lower portion of the structure thus provided I prefer to mount a pillow, cushion, or other similar head-rest`13 upon `which the head of a patient is positioned, substantially as shown in Figs. 1 and 2.

A flexible strap 14, preferably of thin iexible metal, is mounted by means of a pivot l5 upon the lobes olt the lett hand plate 12 (Figs. 1 and 2), and adjacent its pivot said strap is provided with an aperture through which a headed bolt 16 passes. The shank o-said bolt passes through a segmental slot 17 in plate 12 that is concentric with pivot 15, and a wing-nut 18 is screwed upon the ,threaded port-ion of bolt 16 to lock the strap in adjusted positions. A slot 19 extending longitudinally of strap 141- receives a stud or pin 2O upon the adjacent side of a forehead or head clamp 21, and which is adjustably secured to the strap by means oi a wing-nut 22 screwed upon the threaded end of stud 20 after the same is inserted in slot 19 in the strap. The forehead clamp comprises a plate of concave- .convex shape to conform to ythe shape .of the patients forehead, and is preferably made of very thin spring metal so that it will generally shape itself to the contour of this portion of the patients head.

A strap 234 is slidably and pivotally mounted upon the opposite plate 12 by pro- Lriding a longitudinal slot 24 in said strap that co-operates with a stud or pin 25 passing through a segmental slot 26 corresponding with and opposite `the segmental slot 17. oi' the other plate, and which is formed concentric with the pivotal member 27 carried by the respective yplate 12 and extending through slot 241A of the strap. This strap, as well as strap 14, is flexible, being :preferably made of thin spring metal, and may be adjusted upon the plate longitudinally and .pivotally, and is adapted to releasably secure the adjacent end or side portion oil forehead clamp 21 in position. This Ais done by providing a hooked stud 2S upon Vsaid forehead clamp, the recess or depression therein being engaged by an veccentricallymounted cross-piece 29 carried by an operating handle 3() that'is pivoted upon a 'i'nlcrum 81 adjacent the eccentric piece 29, and when in latched position the handle lies flat against the forehead clamp plate 21. In the event it is desired to release the patient, the forehead clamp maybe unlatched by moving handle 30 away Vfrom clamp member 21, as shown in detail in Figs. 5 and 6.

Pivotally 'mounted upon plates 12 by means of `a fulcrum element is a pair of reciprocatory arms 33 that extend upwardly in substantially the direction shown in the drawings, and are provided. with lateral extensions 3d extending at substantially right angles to arms 33 and are threaded to receive the stop-collars 35 screwed thereon. W ing-nuts 35 are also screwed upon extensions Sil toward or spaced from stop-collars 35, and intermediate these two elements .is mounted the bored but unthreaded sleeve 37 to which a cross piece 38 is secured and extends across the lower jaw of the patient, when in position, toward the opposite extension 8d. The bar 38 is shaped, as shown in the drawings, so that it will, when positioned upon the patient, rest in the depression on the lower .jaw just above the chin, which latter usually protrudes slightly, and said bar is releasably connected to extension Si in the manner hereinafter described. The element for engaging the opposite extension consists of a longitudinally split sleeve comprising opposing parts 39a and -Lb, the former carried upon the end of cross-bar 38 and the latter suitably mounted upon a handle element ll0 pivoted upon a pin il carried on an extended portion of bar 3S or upon the counterpart portion 89a of the split sleeve, while a spring` plate4t2 maintains these parts in. their relative adjusted positions, so that when the bar has been placed across the patients chin or lower jaw in the manner shown .in Fig. 1, handle l0 which is in position to open the sleeve, as shown in dotted lines in Fig. a, is swung` downwardly to cause the split sleeve to fold around and engage the adjacent extension 3e between the adjustable stopcollar 35 and wing nut 36 carried by this extension.

The lower jaw eiiga ;ingbar 38 may be adjusted longitudinally upon extensions 34 of arms 33, and when the desired position has been located the same may be locked in place. ln order to open or retract the mouth, the lower jaw is depressed by moving the arms downwardly upon their pivots 32 in the manner shown in Fig. 2 of the drawings. For facilitating` this movement, I have provided handle members 48 extending laterally from arms S3 in the direction opposite but substantially parallel with eX- tensions and connect the outer ends of said handles by a rod lr/1t. These handles and rod form an operating frame and are positioned in such manner that they will clear the crown of the patients head in any of their adjusted positions, and after the patients head has been firmly locked by the forehead clamp, this frame is moved upwardly, as in the direction of the arrow in Fig, l, which causes a retraction of the lower jaw and opens the mouth. Headed bolts d5 pass through segn'iental slots d6 in plates lf2 concentric with the 'fulcrum pin 32 of arms 33 and through apertures in said arms so that after the jaw has been retracted and the mouth opened the desired distance,

arms 33 may be locked in this position by tightening or Lscrewing down wing nuts l? carried upon the outer threaded ends of said bolts 4:5.

ln some persons the chin recedes, instead of protrudes, as in a normal subject. Crossbar 38 would not be so effective upon a chin of this receding type, and to take care of such contingency, I have provided the accessory illustrated in Figs. 8, 9 and 10, which consists of a transverse plate 48 that has an upper hooked end 19 to be positioned upon the teeth or gum of the lower jaw ofthe patient and which is provided with a pad 5t) of rubber, or other similar soft material. rihe plate is provided with a longitudinal slot 51 to permit of longitudinal adjustment to tit the particular patient, and it is locked in its adjusted position by means of a cap screw 53 that passes through said slot 50 and is screwed into threaded aperture or recess 52 in chin bar 38, and in order to facilitate the adjustment of plate 48 the lower endthereof may be provided with an oppositelybent lip 54 by which it may be manipulated to adjust it to the particular patlent.

From the foregoing it will be obvious that in patients having normal bone formation about the chin that the structure may be clamped in position to retain the head rigidly by means of head clamp and its adjustable straps and the chin cross-bar may be adjusted to iit the depression above Vthe chin in the lower jaw, after which handles d3 areraised to depress or retract the lower jaw and open the mouth in which position the structure is locked and no part of the de vice will beinside the patients mouth, which cannot be closed. The only instances in which the teeth or gum of the lower jaw are engaged by my retractor are in such deformities as the receding chin above alluded to and on unruly patients, in which event the hooked plate is employed, which does not vin any way interfere with the operation of the dentist, physician or surgeon. Should the patient indicate strangling or clicking, the operator may at once release the retractor by unlocking split sleeve 39 and 391 and then unlatch the strap or band 23 from the head clamp so that the patient may be free to more as under normal conditions.

lVhat I claim is l. A mouth-gag comprising a head rest having lateral side plates, a forehead clamp coaeting with the side plates of said head rest, arms pivotally mounted intermediate their ends upon the side plates of the head rest, a cross-bar connecting said arms at one end and adapted to engage the patients lower jaw, and a handle element rigidly connecting the opposite ends of said arms.

2. A mouth-gag comprising a head rest, a

forehead cla-mp coacting therewith, arms pivot-ally mounted adjacent the 'head rest, and a cross-bar hingedly mounted upon Aone of' said arms and having a locking engagement with the other arm.

3. A mouth-gag comprising a head rest, a forehead clamp `coacting therewith, Varms pivotally mounted adjacent the head rest, a cross-bar hingedly mounted at one end upon one of said arms, means for adjusting said bar longitudinally upon said arm, and a locking device upon the opposite 'end of said har for releasably securing said har to the other arm.

A ,mouth-gag comprising a head rest, a

forehead clamp coacting therewith and adjustable towards and away from said rest, arms pivotally mounted intermediate their ends adjacent :said head rest, a crossaloar hingedly mounted. at one end upon one -of said arms, means for adjusting said har longitudinally upon said arm, and a locking device upon the opposite end of said har for releasahly securing said bar to the other arm.

5. A mouth-gag comprising a head rest, a forehead clamp coacting therewithv and adjustable toward and away from said rest, arms pivotally mounted intermediate their ends adjacent said head rest, a crosswloar hingedly mounted at one end u-pon one vof said arms, a locking device upon the opposite end of said bar for releasably securing the same to the other arm, and means carried by said arms for adjusting said bar longitudinally thereof.

6. A mouth-gag comprising a pair of spaced side plates, a head rest connecting said plates, straps pivotally and adjustably carried by the respective plates, a forehead clamp connected to said straps, a pair of arms pivotally mounted upon said side plates, and a cross-har connecting said arms and :adapted to engage the patients lower jaw.

7. A mouth-:gag comprising a pair of spaced side plates, a head rest connecting said side plates, straps pivotally and adj ust-- ably carried by the respective plates, a forehead clamp =of concavo-convex shape adjustably connected to said straps, a pair of arms pivotally `mounted upon said side plates, anda cross-bar `connecting said arms and adapted to engage the patients lower jaw.

8. A mouth-gag .comprising a pair of spaced side plates, a lhead lrest connecting said plates, straps pivotally and adjustahly carried -by the respective plates, one of said straps having la longitudinally elongated slot, a forehead clam-p having a threaded stud adjacent lone end and projecting through said slot, a nut gfor ymaintaining said stud in adjusted positions in said slot, a pair of arms pivotal'ly mounted upon said side plates, and a cross-har connecting said arms and adapted to engage the patients lower jaw.

9. A mouth-gag comprising a `pair of spaced side plates, a head rest connecting said plates, straps pivotally `and adjustaloly carried `hy the respective plates and one of said straps having a slot extending longitudinally thereof, a forehead clamp having a threaded stud projecting through said slot, a nut for maintaining said stud in ad justed positions in said slot, means for releasably connecting said clamp to the other strap, a pair of arms pivotally mounted upon said side plates, and a cross-bar connecting said arms and adapted to engage the patients lower jaw.

Signed at Ottumwa, county of VVapello and State of Iowa, November, `1922.

BURDETTE D. LA FORCE.. 

